Saturday, June 24, 2017

My Obamacare Experience and Myth of The Healthcare Queen

Patient Before Surgery

While writhing in pain, I watched the United States Senate roll out their secretly created Obamacare replacement plan was really no different that the hated House of Representatives plan that cut $800 billion from Medicaid and redistributed it to the wealthy as a tax cut. The Senate changed the timing of some changes and attempted to hide takeaways by placing them in opt out options for states. As I sat there listening the “slight of word” doublespeak from one Senator after another the thought in my mind were that you people don’t give a dams about people out here suffering though a sudden medical emergency or dealing with a chronic medical condition.

You see, I am a throwaway line in the healthcare debate. I purchased my insurance through a national exchange provider in a non-Medicaid expansion state and pay 100% of my premiums for my family with $0 subsidies and have done so for years. I’m self-employed. I was watching the Senate Republicans introduce their healthcare dollars redistribution tax cut for the rich disguised as a healthcare plan in utter disgust punctuated by pain. You must understand that my pain had an expiration date and that would be the day I walked in a medical facility for an outpatient procedure to end it. I was trapped between my diagnosis and cure by scheduling dates and access to Dr. and facility, not lack of coverage or money, etc, but all are not so positioned and that was what was pissing me off so much by this new Senate plan.

I have been blessed to be in a position to handle my own business, but the Affordable Care Act allowed millions of people like me to obtain health insurance, period, in spite of some previous diagnosis like high blood pressure or diabetes without being destroyed by premiums higher than those without preexisting ailments. That is the premise of insurance, large payment pool, shared risk with a percentage of use that ensures viability of the overall plan. The Senate bill will eliminate the individual mandate requiring all to purchase insurance or pay a fine, they call it free choice, I call it gutting the premise of insurance period. That mandate increases the pool that supports the plan. Senate Republicans are telling younger, healthier people to be free riders and access healthcare through emergency rooms or doc in the boxes in retail strip shopping centers, guess what; once they access that treatment many of them will have a pre-existing condition. Those healthy young people will not always be that way.
Why do they want to gut Medicaid and what is Medicaid anyway? The following is from the website:

Medicaid is a joint federal and state program that, together with the Children’s Health Insurance Program, provides health coverage to over 72.5 million Americans, including children, pregnant women, parents, seniors and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States.   
In order to participate in Medicaid, federal law requires states to cover certain groups of individuals. Low income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory eligibility groups. States have additional options for coverage and may choose to cover other groups, such as individuals receiving home and community based services and children in foster care who are not otherwise eligible.
The Affordable Care Act of 2010 created the opportunity for states to expand Medicaid to cover nearly all low-income Americans under age 65. Eligibility for children was extended to at least 133 percent of the federal poverty level (FPL) in every state (most states cover children to higher income levels) and states were given the option to extend eligibility to adults with income at or below 133 percent of the FPL. The majority of states have chosen to expand coverage to adults, and those that have not yet expanded may choose to do so at any time.

Why cut Medicaid? Medicaid covers the most vulnerable among us, Low income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) as examples. Obamacare gave states the option to expand Medicaid to cover nearly all low-income Americans under 65 and that is why these Senators want so take $800 billion from Medicaid and give it to the wealthy. Republicans have traded in the term Welfare Queen for a new label Healthcare Queen as a scare tactic. The latest dog whistle of Republicans is tax fairness, basically stoking resentment that those paying taxes are paying for others getting benefits of free healthcare. 
Mick Mulvaney, White House Director of management and Budget wrote said in an article published in the Miami Herald, that many social program users were stealing from taxpayers footing the bills because they didn't intent to pay it back. Mulvaney's attitude is a throwback to the era of the welfare queen talk of years gone by except the word welfare was exchanged for healthcare.

There is only one problem with the tax fairness argument and it not something they can get away with, because most people know someone in their family that are on, have used or will use Medicaid in the future and they are not all in some distant urban ghetto. We are talking about voters’ parents, disabled children or themselves having the rug pulled from under them. I have watched loved ones and friends getting long term nursing home care take their last breaths in nursing homes and did not understand at the time that their financial support for healthcare came from Medicaid. Obamacare's Medicaid expansion pays subsidies so those that financialy qualify now have health insurance, so this is where we are.

Before I could proceed to getting that supremely painful kidney stone laser blasted from by body, I had to settle up financially with the hospital for my portion and did so. A question was asked about what would happen if I didn’t have the money available.  It was explained that people without the means to pay would need to appeal to the hospital board and various factors would be considered.  I wanted the pain to end that was unrelenting and could not imagine having to suffer longer for financial or lack of insurance coverage reasons.
Finally the moment of truth arrived.  After being poked, having blood taken and hooked up to and electrocardiogram machine, the anesthesiologist came in and spoke to me. I signed some consent forms. He inserted a syringe into my IV connection and I recall being wheeled through the day surgery doors and watching my wife make the turn to go to the waiting room. The next thing I recalled was a nurse saying something to me in the same room I was in before the procedure. I opened my eyes and there was no pain. I was told the procedure went flawlessly. I left the hospital with several thoughts. My medical emergency that was not on my radar screen three weeks ago was over. The pain was gone. I was still financially viable in spite of this ordeal due to Obamacare, because my deductible was now met for the year and I was able to get a policy in spite of having a pre-exisiting condition in the first place that was not denied or priced multiple times a healthy individual’s rate.

The primary thought I had was would I transfer to pain I suffered to someone else to suffer longer or get a couple hundred dollar tax cut for myself or for millions of thousands in tax cuts for wealthy individuals just  because they were poor, aged or disabled? The answer is no. Healthcare should be like highways that we all pay for and can use. If someone wants extra then that should be what for profit insurance companies are for just like toll roads. We must remember that health insurance companies are middlemen that pay for healthcare service from actual providers. Medicare does the same thing and pays healthcare bills without a profit added on top. Sure, your plan premiums can be lowered if fewer services are required to be covered, just don’t get sick, old or became disabled. The Republican healthcare plan can lower premiums by allowing states to opt out of certain essential benefits coverage, but that would be like driving on a highway with planned potholes in certain lanes.
These politicians are treating people like property. I am familiar with property insurance and if your home is damaged to the point where it not livable by a covered loss most policies will provide for additional living expense for temporary housing until your home is repaired. If you have rental car coverage on an automobile insurance policy you can get a rental car to use until your car is repaired from a covered loss. If you are struck by an illness or ailment you cannot rent, move into or live in a relative’s body until your body is healed enough for you to move back into like a property insurance claim. The last time people were treated like property in this nation was during slavery.

Health care is personal, intimate and deeply tied to individual self esteem. The sad truth is our lawmakers’ zeal to throw the most vulnerable citizens into a healthcare wasteland for the sake of their wealthy donors show how low we have sunk. Unfortunately profit is the problem, profit from sickness. I know this is a capitalistic society, but like getting on a public highway is the way healthcare should be because it is basic like travel. We would not get very far if the roads were good only in the rich parts of the country. 

Bottom line is that healthcare should be a human right in the United States because I would not wish for anyone else to suffer pain like I had longer than I did due to a lack of money or health insurance coverage to give more money to the wealthiest among us.

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